CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 15940 RVU and Medicare Payment (2026)
Exc ischial pr ulc prim sutr — 9.95 work RVU, about $664.34 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 9.95
- PE RVU (non-facility)
- 7.67
- PE RVU (facility)
- 7.67
- MP RVU
- 2.27
- Office payment
- $664.34
- Facility payment
- $664.34
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 15940 in a non-facility setting with national GPCI: (9.95 + 7.67 + 2.27) × $33.4009 ≈ $664.34. The same code in a facility setting pays about $664.34 because facility PE RVU (7.67) replaces office PE RVU.
What changes by locality
GPCI moves 15940 non-facility payment from $591.45 to $813.12 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 15940?
9.95. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 15940 in 2026?
About $664.34 non-facility ($664.34 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (9.95) and malpractice RVU stay fixed; only practice expense changes (7.67 office vs 7.67 facility). That is the entire office-vs-facility payment gap.